Can Vitamin C supplements cause acute or chronic renal failure? Humans have evolved with very low intakes of vitamin C since the time their primate ancestors lost the ability to naturally synthesize it. Perhaps some people need less vitamin C than others and some people require more vitamin C?

A 31-year-old African-American man presented to the emergency department at the University Medical Center with a 6-day history of headache and a 3-day history of nausea and vomiting. His history was otherwise unremarkable. He denied any recent travel or use of illicit medications, but admitted to the daily use of vitamin C (500 mg tablets, four to five tablets daily) purchased at a local health food store. The following results of physical examination were normal: sodium, 141 mEq/L; potassium, 4.5 mEq/L; chloride, 103 mEq/L; and CO2, 15 mEq/L. The BUN level was 22 mg/d, with a creatinine level of 10.1 mg/dL. A urinalysis showed 2+ protein, 2+ blood, and 0 to 2 WBCs per high-power field without crystals or eosinophils. The total creatine phosphokinase level was 72 U/L, with a serum osmolality of 303 mg/dL. The results of a quantitative toxicology screen for ethanol intoxication and ethylene glycol proved negative. Renal ultrasound revealed increased cortical echogenicity of the kidneys measuring 10 cm and 11.6 cm. A renal biopsy was performed on day 2 (Fig 1 ) and demonstrated acute tubular necrosis and massive oxalate deposition. Treatment with pyridoxine was started on hospital day 4 and was continued until day 9. On further inquiry, the patient was able to recall that he had begun taking even larger numbers of vitamin C tablets a few days prior to the onset of symptoms, up to 10 tablets daily (5,000 mg) due to a recent upper respiratory infection. Antinuclear antibody, antineutrophil cytoplasmic antibody, and antistreptolysin O antibody titers were negative. Complement levels were within normal limits, and HIV serology was negative. The patient underwent two sessions of hemodialysis, with serial measurements of BUN and creatinine showing improvement in renal function. On day 14, measurements showed a BUN of 14 mg/dL and a creatinine level of 2.2 mg/dL; the patient was discharged home, with follow-up in his hometown.

Sat Aug 26, 2006 1:52 am

J.Lilinoe

Re: Renal Failure Due to C?

chimp wrote:

Quote:

but admitted to the daily use of vitamin C (500 mg tablets, four to five tablets daily) purchased at a local health food store.

If he was taking tablets and the tablets contain additives and not the pure stuff, then maybe the additives caused his problem and not the Vitamin C?

In short, it's an interesting case but still a single one. Deficiencies of B6 and Mg (with or without extra Vitamin C) can cause oxalate kidney stones especially if the person in question is dehydrated from say, an upper respiratory infection, like the gentleman in the case study. We also have no idea what this man's kidney function was like prior to the megadosing. He may have already been experiencing renal insufficiency prior to this event. There is also the very large issue of biochemical individuality. Certain individuals will react negatively to just about anything which is why a generalization cannot be made using only case studies. If it were true as a general rule then 90% of the forum participants here would probably already be on dialysis.

If one is going to consume "high" doses of Vitamin C then it behooves him to:
1) Stay hydrated by drinking lots of water (minimum ounces = body weight in pounds devided by 2)
2) Take a B-Complex twice per day
3) Take 400mg of highly bioavailable Mg per day

That said, all decisions including the one to consume "megadoses" of any vitamin entail some risk as does the decision to do nothing at all.

This topic, by the way, is also covered in pages 92-94 of Ascorbate: The Science of Vitamin C by Steve Hickey, Ph.D and Hilary Roberts, Ph.D